Outcome of Rotation Flap Combined with Incisional Negative Pressure Wound Therapy for Plantar Diabetic Foot Ulcers

Area of Science:

• Plastic Surgery
• Wound Healing
• Diabetology

Background:

• Diabetic foot ulcers (DFUs) are a common complication affecting 20% of diabetic patients.
• Plantar DFUs present unique challenges due to weight-bearing.
• Conventional treatments for DFUs often yield suboptimal outcomes.

Purpose of the Study:

• To evaluate the efficacy of rotation flap reconstruction combined with incisional negative pressure wound therapy (NPWT) for plantar DFUs.
• To assess healing rates, complication rates, and recurrence rates associated with this combined approach.

Main Methods:

• Retrospective review of 42 patients undergoing rotation flap closure for plantar DFUs.
• Preoperative optimization included infection control and vascular assessment.
• Rotation flaps were performed with incisional NPWT, followed by offloading and continuous incisional NPWT postoperatively.

Main Results:

• All 42 patients achieved initial wound healing within a median of 36 days.
• Complications were observed in 14% of cases.
• A 21% recurrence rate was noted, significantly higher in patients with Charcot foot deformity.

Conclusions:

• Rotation flap closure with incisional NPWT is a viable and effective treatment for plantar DFUs.
• This method achieves high initial healing rates and low complication rates.
• Patients with Charcot foot deformity require specialized attention to minimize recurrence risk.